Mobile phone-based screening for anemia in young children in western Kenya

基于手机的肯尼亚西部幼儿贫血筛查

• 批准号: 10752968
• 负责人: Patrick Thomas McGann
• 金额: $ 38.32万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2025-08-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10752968
• 关键词: 5 year old; Address; Affect; Anemia; Birth; Cellular Phone; Child; Chronic Disease; Clinical; Collaborations; Communities; Country; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Disease; Etiology; Feasibility Studies; Funding; Goals; Guidelines; HIV; Health; Health system; Hemoglobin; High Prevalence; Income; Individual; Infant; Infection; Intervention; Iron; Kenya; Laboratories; Laboratory Study; Life; Link; Longevity; Malaria; Measurable; Measurement; Measures; Methods; Modeling; Morbidity - disease rate; Outcome; Outcome Study; Pathway interactions; Persons; Phase; Physical Examination; Population; Populations at Risk; Public Health; Recurrence; Research; Research Proposals; Screening procedure; Sickle Cell Anemia; Structure of palpebral conjunctiva; Technology; Testing; United States National Institutes of Health; Vascular blood supply; Visit; Work; acceptability and feasibility; accurate diagnostics; cohort; community engaged research; community engagement; conjunctiva; cost; diagnostic accuracy; diagnostic algorithm; diagnostic tool; early childhood; effective therapy; evidence base; follow-up; health care availability; high risk; high risk population; implementation barriers; implementation facilitators; implementation measures; implementation outcomes; implementation science; improved; innovation; iron deficiency; low and middle-income countries; mHealth; mortality; neglect; noninvasive diagnosis; novel; novel diagnostics; point of care testing; point-of-care diagnostics; prevent; programs; prospective; routine care; routine screening; screening; screening guidelines; screening program; technology development; tool; treatment guidelines; treatment planning; treatment program

PROJECT SUMMARY/ABSTRACT Anemia is a common, serious, and neglected global public health problem, affecting over 2 billion people with especially high prevalence among children in low-and middle-income countries (LMICs). Unfortunately, despite the high prevalence and negative health consequences of anemia, few routine screening programs exist in LMICs. There is a critical need to identify an easy-to-implement, low-cost strategy to screen and treat anemia and its causes in LMICs, where > 50% of the population and as many as 75% of children under-5 years of age suffer from anemia. In many LMICs, anemia goes undiagnosed, primarily due to lack of access to accurate and affordable laboratory diagnostics. The most common global causes of anemia (iron deficiency, malaria, sickle cell disease) are relatively easy to diagnose with highly effective treatments. Children with chronic illnesses such as HIV are at an even higher risk of anemia with a significant impact on health outcomes. In most high-income countries, infants are universally screened at birth for sickle cell disease and are routinely screened for anemia at least once in early childhood. This screening and treatment paradigm is highly effective and averts the significant morbidity and early mortality associated with anemia. In LMICs, although >50% of children are anemic, there is no systematic screening and limited capacity to diagnose sickle cell disease, iron deficiency, or other underlying causes of anemia when it is detected. The lack of diagnostic laboratory capacity to measure hemoglobin concentration accurately and affordably is a primary limitation to the systematic identification of anemia. In this study, we will use a smartphone-based, noninvasive method to measure hemoglobin and detect anemia by analyzing photos of the palpebral conjunctiva. This smartphone-based method has been shown to accurately measure hemoglobin in a controlled setting in the US but has not been rigorously evaluated in settings where more severe anemia is common. In this study, we will evaluate the utility and accuracy of this mobile health (mHealth) tool to diagnose anemia among young children in western Kenya. Through the R21 phase, we will (Aim 1) develop a community advisory board to proactively consider acceptability and feasibility of this screening intervention and develop an implementation plan and (Aim 2) evaluate the diagnostic accuracy of this mHealth tool in detecting anemia among Kenyan children who are HIV-exposed and unexposed, within the context of multiple etiologies of anemia. If found to be valid, use of this anemia screening tool will be integrated into the health system, according to the implementation plan developed by the Community Advisory Board. We will measure implementation outcomes of the screening program and prospectively evaluate a disease-specific follow-up and treatment plan to assess the clinical impact of this mHealth-based anemia screening and treatment program for children living in western Kenya. This research has important implications to demonstrate the feasibility of an mHealth anemia screening tool and will address a critical gap towards addressing the neglected global burden of anemia.

项目总结/摘要 贫血是一种常见、严重和被忽视的全球公共卫生问题，影响着20多亿人， 特别是在低收入和中等收入国家（LMIC）的儿童中，不幸的是，尽管 由于贫血的高患病率和负面健康后果， 中低收入国家。迫切需要确定一种易于实施、低成本的策略来筛查和治疗贫血 在中低收入国家，超过50%的人口和多达75%的5岁以下儿童 患有贫血症。在许多低收入国家，贫血得不到诊断，主要是因为缺乏准确和有效的诊断方法。 负担得起的实验室诊断。全球最常见的贫血原因（缺铁、疟疾、镰刀 细胞疾病）相对容易用高效的治疗方法诊断。患有慢性疾病的儿童， 因为艾滋病毒感染者患贫血的风险更高，对健康结果有重大影响。在大多数高收入 在一些国家，婴儿在出生时普遍接受镰状细胞病筛查，并定期接受贫血筛查。 至少在童年早期有一次。这种筛查和治疗模式非常有效， 与贫血相关的显著发病率和早期死亡率。在中低收入国家，尽管>50%的儿童贫血， 没有系统的筛查，诊断镰状细胞病、缺铁或其他疾病的能力有限。 贫血的根本原因，当它被发现。缺乏诊断实验室能力， 血红蛋白浓度的准确性和经济性是系统识别的主要限制。 贫血在这项研究中，我们将使用一种基于智能手机的非侵入性方法来测量血红蛋白并检测 贫血通过分析照片的睑结膜。这种基于智能手机的方法已被证明 在美国的受控环境中准确测量血红蛋白，但尚未在环境中进行严格评估 在那里更严重的贫血很常见。在这项研究中，我们将评估这种移动的的实用性和准确性 健康（mHealth）工具来诊断肯尼亚西部幼儿的贫血。在R21阶段，我们 我会（目标1）成立一个社区咨询委员会，积极考虑这项建议的可接受性和可行性 筛选干预，并制定实施计划，并（目标2）评估诊断的准确性， 移动健康工具，用于检测肯尼亚艾滋病毒感染和未感染儿童的贫血症， 贫血的多种病因背景。如果发现有效，将整合使用此贫血筛查工具 根据社区咨询委员会制定的实施计划，将这一方案纳入卫生系统。我们 将衡量筛查计划的实施结果，并前瞻性地评估疾病特异性 随访和治疗计划，以评估这种基于mHealth的贫血筛查和治疗的临床影响 为生活在肯尼亚西部的儿童提供的项目。这项研究具有重要的意义，以证明 一个移动健康贫血筛查工具的可行性，并将解决一个关键的差距，解决被忽视的 全球贫血负担。